Caregivers of perinatally acquired HIV face high risk of depression

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In South Africa, biological mothers frequently carry the double burden of living with HIV themselves as well as caring for their children with the same condition. Photo: iStock
In South Africa, biological mothers frequently carry the double burden of living with HIV themselves as well as caring for their children with the same condition. Photo: iStock

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Caregivers of adolescents with perinatally acquired HIV (PHIV) are at high risk of depression. This is according to a study by mental health experts at the University of Cape Town (UCT).

This unprecedented study found that depression in caregivers was associated with poor physical health and poor overall quality of life, as well as externalising and internalising behaviour problems in PHIV patients.

The research paper, titled A longitudinal and qualitative analysis of caregiver depression and quality of life in the Cape Town Adolescent Antiretroviral Cohort, is published in the Journal of Affective Disorders Reports.

READ: Clinics gamble with HIV patients’ lives

Professor Jackie Hoare, the head of the division of consultation liaison psychiatry and the study’s principal investigator, said: “With increased access to antiretroviral therapy, more children living with HIV are surviving into adolescence. In South Africa alone, there are 360 000 adolescents between the ages of 10 and 19 living with HIV, and many with PHIV.”

She said that, in South Africa, biological mothers frequently carried the double burden of living with HIV themselves as well as caring for their children with the same condition.

She said: 

In addition, many children orphaned due to HIV and Aids are cared for by their grandmothers, aunts or older siblings, who, in many cases, already have other children to care for. This added responsibility often takes a toll on the caregivers’ mental health.

Hoare said women were more likely to take on the role as a caregiver for numerous reasons, such as traditional gender roles and an absence of men in the household due to death, abandonment or income-generation activities.

“Studies have indicated that, if the biological mother has died or can no longer take care of her children, then the grandmother will normally take on this role,” she said.

According to experts, the findings highlight the need for adequate intervention strategies to provide resources and social support to caregivers to improve their mental health.

READ: 'A quarter of new HIV infections in young women due to gender-based violence'

The study assessed depression, socioeconomic factors and quality of life in 121 caregivers, at the baseline and 36-month follow-up.

The research read: 

With increased access to resources and social support and improvement of physical health and overall quality of life, the study found that the risk of depression in caregivers decreased significantly at follow-up.

The experts cited that caring for PHIV adolescents brought new and unique challenges compared with caring for younger children and infants living with HIV, which may contribute to decreased caregiver depression at follow-up. One reason was that adolescents were able to make more autonomous decisions and may demand less attention from their caregivers.

Hoare said it was important to encourage men to take more responsibility in caring for PHIV adolescents.


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